Anniversary

One thing that puzzled me during our plan of celebrating the 24th wedding anniversary was all the coinciding with official release of Taylor Swift's 11th studio album. I joked about Taylor Swift choosing to celebrate our big day.

Taylor's new album is likened to a new star in the galaxy, and her music has been a global phenomenon. 

My daughter, like all other Swifties, has been head over heels for her, and more so in the days leading up to the release of "The Tortured Poet Department". Out of loyalty to their favorite singer, Swifties refused to listen to the songs leaked online early. Because of school schedule, my daughter had to wait few hours after the album's arrival to start listening. She made promise not to log into any social media during lunch break in case of spoilers.

As it turns out, one of the celebration events for our wedding anniversary yesterday was to drive to my daughter's school and pick up two Swifties to our home – to make the history. In case you don't know, Taylor's album takes less than 12 hours to break this year's record for most single-day Spotify streams.

Mental

The story of Michael Laudor, as told by acclaimed author Jonathan Rosen, was heartrending. The author, Michael’s closest childhood and lifelong friend, wrote a story spanning 50 years which took me two weeks to finish. 

In terms of language prowess and intelligence, Michael Laudor could take pride in his encyclopaedia recall, like reading a book in one sitting without losing a word. He read faster than Rosen, remembered more, and processed information more quickly. 

The way Michael studied was not for the faint of hearts. His roommate had to move out because Michael never put his reading light out no matter how often he was asked or how late it got. He ended up inheriting a room of his own, which everyone in the college called “psycho singles.” 

During his first semester at Yale with Rosen, Michael had made a dive into a thorny debate with a Harvard professor who wanted Black parents to decide for themselves whether their kids got bused to majority-white schools or stayed close to home where, Michael warned, they would “suffer from the loss of an integrated environment.” Michael published a long letter in The New York Times defending the racial balance in public schools. Michael had superior intellectual ability. We took it for granted that Michael would rise to scholar status. It never occurred to us that he might one day became the man who needed to be judged as whether to be integrated or to be locked. 

He graduated from Yale Law School with summa cum laude honors despite suffering from schizophrenia. “Either you welcomed people with disabilities to the table,” he later wrote, “or you cast them out like lepers shunned in earlier times.” His story made us think again the way to help people with mental health problems. That’s something even bright guy like Michael doesn’t know the answer.

Out of the Box

I happened to be reading Ozan Varol's book two days ago, when I was on call looking after patients with kidney disease. As a rocket scientist turned award-winning author, Ozan Varol championed moving out of our comfort zone. That means taking off the training wheels and moving away from the familiar path.

One of my call duties was to look after and orchestrate kidney transplant from a brain death donor after a tragic traffic accident. My two patients were waiting for the new kidneys. They didn't speak much, and somewhere in the background rose the ticking of the clock in our medical ward, an unwavering rhythm of stability, sharply at odds with the uncertainty on their faces. I was counting my fingers. We weren't sure how long the wait would be. Waiting, for my patients on dialysis, was a bitter cocktail of aching awareness, visceral pain, and mental crush.

The organs had already been taken out of the road crash victim's body for over ten hours. I didn't want to disclose too much to the two taciturn kidney transplant candidates how we are in a race against the clock as soon as a kidney was recovered and placed on ice. Patients should not be bothered with the science that kidneys would start to degrade during the high-stakes window called cold ischaemic time. Yes, prolonged cold storage of kidneys inside the box is no laughing matter – there are starving kidneys at stake – but, hard as we tried, our operating rooms were all occupied with emergency surgery that afternoon.

Ozan Varol reminds me the pitfall of managing uncertainty. In other words, our brain often steers us toward the seemingly safest path – inaction. The brain, to paraphrase psychologist Rick Hanson, is like Velcro for the negative but Teflon for the positive.

To overcome the uncertainty, my urologist friend and I quickly threw away the training wheels and old rules. We tried out best to generate as many new ideas as we could. So we explored the idea of transporting the kidney organ and patient to another hospital nearby, where we can operate. Before we worked out the plan in more detail, we were told the availability of operation room in our hospital. Not one but two. If we followed our tradition like what we have been doing for the last twenty years, we would have sent the first patient to have the kidney transplant operation, and then the next one. One after another. Such tendency to follow the tradition isn't too wrong, but it means another few hours' wait for the second kidney. We knew the kidneys' quality would be better if we can beat the clock. At the end of the day, we were able to gather more than six hardworking surgeons, not to mention two teams of anaesthetists, to carry out two kidney transplant operations in parellel. Wait. I shouldn’t say “at the end of the day”; our transplant surgery started at one in the very early morning.

I am really grateful. Two days later, I am still telling it.

Dead

Unlike buying cinema tickets, on-demand streaming platform lets us enjoy more movies than we can imagine. The good part about the streaming service is that there's always chance to stop and switch.

When our family first picked the superhero movie Deadpool today, we didn't realise the bloody violence scenes throughout the story based on the Marvel Comics. That unsettled us. So much so that we stopped watching within the first ten minutes.

We were disappointed, but not for long. We went for another movie, Dead Poets Society, which was released in 1989. Looking back, I think we have made a smart choice out of the two movies, both starting with "Dead". The classic Dead Poets Society tells the story of an English teacher, Keating the "O Captain! My Captain!". Keating loved encouraging his students to go with their hearts instead of pursuing conformity. His philosophy of carpe diem, obviously, won't be accepted by the older generations. That's why one of the parents wanted to cut his son's extracurricular activities at all costs. He simply wished his son to study hard for his chemistry or science lessons. Some lesson are harder to learn that others, and the one for his son Neil Perry - that acting is more meaningful than studying medicine - was tragic for all parties.

The movie brought tears to our eyes in the family, and if the story of Keating and Neil doesn’t break your heart, well, I don’t know what will.

Exercise

How many of us have dreamt of living better longer? I know I have.

Today, voluminous research has shown that mortality is an inevitable companion of aging and chipping away one disease at a time is futile, like rearranging deck chairs on the Titanic. The good news, though, is that exercise is the most potent pro-longevity "drug". I was introduced to this strategy by Peter Attia in his eye-opening book Outlive. In short, medicine's biggest failing is in attempting to treat all the conditions at the wrong end of the timescale - after they are entrenched - rather than before they take root.

The beauty of maintaining health by exercise is to make us functionally younger. If anything, we exercise to live longer with good function and without chronic disease, and with a briefer period of morbidity at the end of our lives. The upside of training to improve our VO₂ max during physical exertion is huge. One study found that boosting elderly subjects' VO₂ max by about 25 percent was equivalent to subtracting twelve years from their age.

What better drug can give us such payoff? 

True

For years, we love reading crime stories or psychological thrillers.

Unsettling as they're, these fictions give us irresistible pleasure from the adrenaline swooshing through the bloodstream, not to mention the Hitchcockesque entertainment of decoding mystery.

It would be easy, and oh so helpful, for authors to stick to the theme of telling lies. My daughter finished One of Us is Lying not long ago. I just read None of This is True.  

All these books are destined to end with a maze twisted by the somewhat sickening knots of truths and untruths. All of which is to say, deception is an endless trick to make stories riveting. A bit frightening, perhaps. 

Luckily, we have more truths than lies in our real life. For me, at least.

Ando

I doubt many outside the field of architecture have heard of Tadao Ando. Few inside the field, somehow, know that he was born in poverty, had been raised by his grandmother and was a boxer, before he started teaching himself architecture. I learrned his story from Adam Grant's book Hidden Potential.  

As the only architect ever to win all four of the field's most prestigious prizes, his success has come with an asterisk. Without means to go to college, Ando borrowed architecture books from friends and taught himself enough to earn an architecture license. 

By the time he has become the master of light and concrete, he has identified his goal. "What some other people think of my work is not my prime mover," he says. "It's my desire to satisfy me, and to challenge myself."

That's contrary to what most of us have in mind. One could take the view – and I would bet that many do – that it's important to meet other people's expectation. Like Ando, Adam Grant reminds us it's better to disappoint others than to disappoint ourselves. It's more about living up to our own standards.

To visualise what we're facing, Adam Grant makes use of a soccer pitch diagram to depict the size of people we try to please. For that matter, the penalty area inside the whole pitch are somewhat representing the percentage of people we can actually please. And then, an even smaller square – the goal area – refers to the proportion of people (including yourself, of course) we should focus on pleasing. 

That reminds me of my pacing during my run after work. I seldom join running competition. I run myself. My pace, interestingly, goes up after seeing guys riding bike next to me. That's extrinsic goal to drive me. To beat the odds. And, most importantly, to beat myself.